Dr. Lombardo is a board-certified adult, child and adolescent psychiatrist and a diplomat of the American Society of Clinical Psychopharmacologists. In addition, he holds a doctorate in English literature. He practices in Katonah , N.Y. , and in New York City . He recently wrote a book about bipolar called “Understanding the Mind of Your Bipolar Child: The Complete Guide to the Development, Treatment, and Parenting of Children with Bipolar Disorder.”

At the February meeting, Dr. Lombardo explained to the group that bipolar can sometimes appear as ADHD. But, contrary to ADHD, which involves an abnormality in the frontal cortex, bipolar disorder involves an abnormality in the limbic system, which is deep in the lower brain. Although they often look the same; ADHD is characterized by the child's inability to pay attention because he cannot focus, and bipolar is characterized by the child’s inattentiveness because of the heightened activity in his brain.

A telltale sign in a baby who is vulnerable to bipolar is difficulty settling down. Babies with bipolar disorder vulnerability tend to be colicky (although not all colicky babies are predisposed to bipolar). They take a long time to learn to sleep through the night and often exhibit symptoms of sensory integration disorder - hyper-sensitivity to sound and touch.

Bipolar children often have difficulty mastering developmental tasks. Because of their impulsivity and low frustration tolerance they are particularly resistant to accepting limits, Dr. Lombardo said.

When starting school, bipolar children are prone to experience separation anxiety and panic attacks. They find it difficult adjusting to school, accepting limits, and concentrating on school work. Their failure at acquiring academic skills often haunts them all the way through school and is a source of other problems, such as low self esteem.

The impulsivity and intense anger associated with bipolar often create difficulty for these children to get along with their peer group.

According to Dr. Lombardo, bipolar disorder is currently underdiagnosed in children and adolescents. Health professionals who do not regularly work with a bipolar population expect to see the usual symptoms of manic-depression disease: the periodic cycling between mania and extreme depression. However, bipolar does not always present in the classic form, especially in children and adolescents. Sometimes it presents itself as extreme irritability, or rapid cycling. According to Dr. Lombardo, bipolar is a spectrum disease. On one end we find bipolar II with the classic manic-depressive symptoms, and on the other end we find cyclothymia, which presents with milder symptoms.

Dr. Lombardo discussed the medications currently prescribed for BIPOLAR DISORDER. He talked particularly about lithium and Lamictal. Lithium has been used for BIPOLAR DISORDER since the 1940s and is still being used despite some unpleasant side effects because of its effectiveness. Lamictal (lamotrigine) is a newer medication and was originally prescribed for seizures. Besides a rare but potentially dangerous autoimmune response, it does not have any major side effects and is a very effective treatment for bipolar disorder.

A major concern in prescribing medications for bipolar children is the possibility that antidepressants will trigger a manic attack or generate suicidal ideation. Dr. Lombardo speculated that the spat of Prozac suicides reported in the last few years had to do with bipolar patients who were misdiagnosed.

Parenting bipolar children can be challenging, emphasized Dr. Lombardo. They are often impatient, impulsive, and difficult to manage. Parents should try to stay calm. However it is important that they set limits and hold them, he said.

The group discussed the apparent rise in the diagnosis of bipolar disorder in recent years. Although this can be correlated to the better understanding of the disorder following accumulated research, some members of the group wondered if it was possibly correlated to the increase in vaccination of babies. Others wondered whether current diets, high in sugar and preservatives, were a contributing factor.

Dr. Lombardo expressed his optimism about the future of treatment for bipolar disorder. Mental health research has made major strides in the last couple of decades in understanding the human brain and mental illness. He predicted that the future will bring better and safer medications for bipolar patients.

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http://www.news14charlotte.com/content/local_news/cleveland/?ArID=105967&SecID=6 ).

Dr. Mark Banschick, who has been presenting nationwide on the issue of kids in cyberspace, gave a talk on this subject at a conference of Jewish Orthodox mental health professionals that took place in the middle of February in Jerusalem .

According to the Jerusalem Post, which ran a story on his presentation, Dr. Banschick likened the Internet to the introduction of cars in 1885. Cars have given us mobility but also brought with them car accidents. Similarly, the Internet has positive as well as negative effects. It democratizes the availability of information, but at the same time it can be used as a tool to hurt people, especially among kids and adolescents. An ominous aspect of the Internet is its ability to facilitate predatory behavior. “Most pedophiles would never have become pedophiles 30 years ago, before the Internet. Now they have an opportunity because access is easier," Dr. Banschick said. ( Jerusalem Post).

Kids can lead secret lives on the Internet that are often detrimental to their mental health. For example, kids who suffer from bulimia can contact other bulimics on the Internet and be encouraged to continue in their harmful behavior, according to Dr. Banschick. In addition, kids as well as adults can become addicted to the Internet and spend many hours surfing the net and IMing, all at the expense of other, healthier activities.

Dr. Banschick recommended that schools offer classes on the use of the Internet as part of their curriculum. For parents, he recommended checking the Internet history file (located in the Windows directory), which contains the visited Web sites, and restricting surfing hours.

For the full Jerusalem Post article, please follow this link: http://www.jpost.com/servlet/Satellite?cid=1171894562109&pagename=JPost%2FJPArticle%2FPrinter

Mark Banschick, MD, is a child and adolescent psychiatrist in practice in Katonah , N.Y. He is a cofounder of the Katonah Study Group and an adjunct professor at Hebrew Union College .

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